• Title/Summary/Keyword: Malignant obstruction

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Low Grade Pulmonary Lymphomatoid Granulomatosis with an Endobronchial Mass

  • Kim, Kyung Hoon;Park, Jinhee;Yoo, Ji Yeon;Kim, Min Jae;Kim, Il;Rhee, Chin Kook;Lee, Hea Yon
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.2
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    • pp.137-141
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    • 2015
  • Lymphomatoid granulomatosis (LYG) is an angiocentric and angiodestructive neoplastic proliferation of B and T lymphocytes commonly involving the lungs. Epstein-Barr virus is commonly detected in lesional cells. We report a case of a 54-year-old female with underlying monoclonal gammopathy of unknown significance who presented with a 4 week history of dyspnea and cough. Computed tomography scan of the chest showed multiple lung nodules as well as endobronchial narrowing causing atelectasis at the left upper lobe. Bronchoscopic findings revealed obstruction at the lingula segment due to endobronchial mass as a rare presentation. Bronchoscopic biopsy was diagnosed with LYG grade 1. After treatment, the endobronchial mass and lung lesions were completely resolved. However, the patient eventually evolved to malignant lymphoma after 1 year.

A Case of Hemangioma of Nasal Cavity in Von Hippel-Lindau Syndrome (Von Hippel-Lindau 증후군 환자에서 발생한 비강내 혈관종)

  • Hyun Seok Kang;Soo Jin Jung;Seoung Wan Chae;Seok Jin Hong
    • Korean Journal of Head & Neck Oncology
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    • v.39 no.2
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    • pp.65-69
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    • 2023
  • We report a unique case of hemangioma of the nasal cavity in von Hippel-Lindau (VHL) syndrome. A 26-year-old female with VHL syndrome who had previously undergone surgery for pancreatic and adrenal mass presented with a 4-month history of left-sided nasal obstruction. The patient had an expansile mass lesion in the left nasal cavity and an imaging test demonstrated the mass in the left maxillary sinus extending to the nasal cavity. The tumor was removed with an endoscopic prelacrimal recess approach considering the possibility of not only a benign tumor such as hemangioma but also a malignant tumor of the maxillary sinus and histopathologic examination confirmed cavernous hemangioma. This case is the rarely reported manifestation of the paranasal sinus in VHL disease.

Endoscopic ultrasound-guided portal vein coiling: troubleshooting interventional endoscopic ultrasonography

  • Shin Haba;Kazuo Hara;Nobumasa Mizuno;Takamichi Kuwahara;Nozomi Okuno;Akira Miyano;Daiki Fumihara;Moaz Elshair
    • Clinical Endoscopy
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    • v.55 no.3
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    • pp.458-462
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    • 2022
  • Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS) is widely performed not only as an alternative to transpapillary biliary drainage, but also as primary drainage for malignant biliary obstruction. For anatomical reasons, this technique carries an unavoidable risk of mispuncturing intrahepatic vessels. We report a technique for troubleshooting EUS-guided portal vein coiling to prevent bleeding from the intrahepatic portal vein after mispuncture during interventional EUS. EUS-HGS was planned for a 59-year-old male patient with unresectable pancreatic cancer. The dilated bile duct (lumen diameter, 2.8 mm) was punctured with a 19-gauge needle, and a guidewire was inserted. After bougie dilation, the guidewire was found to be inside the intrahepatic portal vein. Embolizing coils were placed to prevent bleeding. Embolization coils were successfully inserted under stabilization of the catheter using a double-lumen cannula with a guidewire. Following these procedures, the patient was asymptomatic. Computed tomography performed the next day revealed no complications.

High-Dose-Rate Intraluminal Brachytherapy for Biliary Obstruction by Secondary Malignant Biliary Tumors (속발성 담도부 종양에 의한 담도 폐쇄에서 고선량률 관내 근접치료)

  • Yoon Won-Sup;Kim Tae-Hyun;Yang Dae-Sik;Choi Myung-Sun;Kim Chul-Yong
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.35-43
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    • 2003
  • Purpose :To analyze the survival period, prognostic factors and complications of patients having undergone high-dose-rate intraluminal brachytherapy (HDR-ILB) as a salvage radiation therapy, while having a catheter, for percutaneous transhepatic billary drainage (PTBD), inserted due to biliary obstruction caused by a secondary malignant biliary tumor Methods and Materials : A retrospective study was performed on 24 patients having undergone HDR-ILB, with PTBD catheter Insertion, be)ween December 1992 and August 2001. Their median age was 58.5, ranging from 35 to 82 years. The primary cancer site were the stomach, gallbladder, liver, pancreas and the colon, with 12, 6, 3, 2 and 1 cases, respectively. Eighteen patients were treated with external beam radiation therapy and HDR-lLB, while slx were treated with HDR-lLB only. The 4otal external beam, and brachytherapy radiations dose were 30$\~$61.2 and 9$\~$30 Gy, with median doses of 50 and 15 Gy, respectively. Results : Of the 24 patients analyzed, 22 died during the follow-up period, with a median survival of 7.3 months. The 6 and 12 months survival rates were 54.2 (13 patients) and 20.8$\%$ (5 patients), respectively. The median survivals for stomach and gailbladder cancers were 7.8 and 10.2 months, respectively, According to the unlvariate analysis, a significant factor affecting survival of over one year was the total radiation dose (over 50 Gy) (o=0.0200), with all )he patients surviving more than one year had been Irradiated with more than 50 Gy. The acute side effects during the radiation therapy were managed with conservative treatment. During the follow-up period, 5 patients showed symptoms of cholangltis due to the radiation therapy Conclusion :An extension to the survival of those patients treated with HDR-ILB is suggested compared to the median historical survival of 4hose patients treated with external biliary drainage. A boost radiation dose could be effectively given, by performing HDR-lLB, which is a prognostic factor In addition, the acute complications of radiation therapy were effectively controlled by conservative management, and It could be regarded as a safe treatment.

A GFP-labeled Human Colon Cancer Metastasis Model Featuring Surgical Orthotopic Implantation

  • Chen, Hong-Jin;Yang, Bo-Lin;Chen, Yu-Gen;Lin, Qiu;Zhang, Shu-Peng;Gu, Yun-Fei
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4263-4266
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    • 2012
  • Colorectal cancer has become a major disease threatening human health. To establish animal models that exhibit the characteristics of human colorectal cancer will not only help to study the mechanisms underlying the genesis and development effectively, but also provide ideal carriers for the screening of medicines and examining their therapeutic effects. In this study, we established a stable, colon cancer nude mouse model highly expressing green fluorescent protein (GFP) for spontaneous metastasis after surgical orthotopic implantation (SOI). GFP-labeled colon cancer models for metastasis after SOI were successfully established in all of 15 nude mice and there were no surgery-related complications or deaths. In week 3, primary tumors expressing GFP were observed in all model animals under fluoroscopy and two metastatic tumors were monitored by fluorescent imaging at the same time. The tumor volumes progressively increased with time. Seven out of 15 tumor transplanted mice died and the major causes of death were intestinal obstruction and cachexia resulting from malignant tumor growth. Eight model animals survived at the end of the experiment, 6 of which had metastases (6 cases to mesenteric lymph nodes, 4 hepatic, 2 pancreatic and 1 mediastinal lymph node). Our results indicate that our GFP-labeled colon cancer orthotopic transplantation model is useful with a high success rate; the transplanted tumors exhibit similar biological properties to human colorectal cancer, and can be used for real-time, in vivo, non-invasive and dynamic observation and analysis of the growth and metastasis of tumor cells.

Bowel Sound Recording for Structural Deformity in the Pylorus-Duodenum: Report of 3 Cases (각기 다른 유문-십이지장의 기질적 병변 3증례에 대한 장음 측정 보고 : 장음의 주주파수를 중심으로)

  • Yoon, Sang-hyub
    • The Journal of Internal Korean Medicine
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    • v.36 no.3
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    • pp.276-283
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    • 2015
  • Objectives: The purpose of this study is to report bowel sound patterns recorded in 3 diseases associated with structural deformity of the pylorus-duodenum. Methods: : Bowel sound recording is a useful non-invasive tool for the evaluation of gastrointestinal motility. However, the difficulty in manual attachment of the electronic stethoscope on the abdominal wall and noise production against bowel sound signals have prohibited its widespread use. Therefore, I developed a new apparatus that eliminates the noise; it contains a sound absorbing device and a holder for the head of stethoscope. Using the new bowel sound recording system, bowel sounds of the patients were recorded repeatedly. The endoscopic and abdominal computed tomography findings were obtained from other hospitals' medical record, and all patients were confirmed to have structural deformity in the pylorus-duodenum. The records of each patient were compared and assessed. Results: : Patients had either duodenal ulcer scar, pyloric stricture, or far advanced malignant stomach cancer, as diagnosed by the gastroscopy. Their dominant frequency of bowel sound obtained from the new system was checked more than 2 times at regular intervals. All 8 recordings in the 2 patients with duodenal ulcer scar (5 times) or pyloric stricture (3 times) showed a decrease in postprandial than fasting dominant frequency. One patient with stomach cancer showed no significant change between postprandial and fasting states at 2 recordings. Conclusions: The analysis of dominant frequency in bowel sounds can indicate the existence of pyloric obstruction that could delay gastric emptying.

Acute Surgical Abdomen in Childhood Malignancies (소아암환자에서 발생하는 급성 복증)

  • Park, Byung-Kwan;Moon, Suk-Bae;Jung, Sung-Eun;Jung, Kyu-Whan;Park, Kwi-Won
    • Advances in pediatric surgery
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    • v.15 no.2
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    • pp.103-112
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    • 2009
  • Catheter related and perianal problems are common surgical complications encountered during the treatment of pediatric malignancies. However acute surgical abdominal emergencies are rare. The aim of this study is to review acute surgical abdominal complications that occur during the treatment of childhood malignancies. Out of a total of 1,222 patients who were newly diagnosed with malignant disease, between January 2003 and May 2008, there were 10 patients who required surgery because of acute abdominal emergencies. Their medical records were reviewed retrospectively. Hematologic malignancies were present in 7 patients (4 leukemia, 2 lymphoma, 1 Langerhans cell histiocytosis) and solid tumors in 3 patients (1 adrenocortical carcinoma, 1 desmoplastic small round cell tumor, 1 rhabdomyosarcoma). Seven patients had intestinal obstruction, two had gastrointestinal perforation and one, typhlitis. Intestinal obstructions were treated with resection of the involved segment with (N=2) or without (N=3) enterostomy. Two patients had enterostomy alone when resection could not be performed. Intestinal perforation was treated with primary repair. Typhlitis of the ascending colon was treated with ileostomy. Right hemicolectomy was necessary the next day because of the rapidly progressing sepsis. Three patients are now alive on chemotherapy and one patient was lost to followed-up. Among six patients who died, five died of their original disease progression and one of uncontrolled sepsis after intestinal perforation. Although rare, acute surgical abdominal complications can occur in childhood malignancies. Rapid and accurate diagnosis and appropriate operation are required for effective treatment of the complications.

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Leiomyosarcoma of the Inferior Vena Cava - A case report - (하대정맥에 발생한 평활근육종 - 1예 보고 -)

  • Park, Jae-Hong;Kim, Myoung-Young;Hwang, Sang-Won;Kim, Han-Yong;Yoo, Byung-Ha
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.275-278
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    • 2009
  • Leiomyosarcoma of the inferior vena cava (IVC) is a rare malignant tumor. Yet tumors of a smooth muscle origin are the most common primary neoplasms of the major veins, and the inferior vena cava is the most common site of origin. We report here on a 65-year-old female patient who had been suffering from dyspnea and abdominal discomfort for 3 weeks before admission. The abdominal computed tomography (CT) scan and IVC cavogram showed an IVC mass extending from the right atrium to above the level of the right renal vein, obstructing the IVC, and the radiological findings were suggestive of an IVC leiomyosarcoma. We resected the tumor and reconstructed the IVC with a patch PTFE graft. The follow-up abdominal CT revealed no recurrence and obstruction of the IVC for 6 months after the operation.

Pulmonary epithelioid hemangioendothelioma misconceived as pulmonary metastasis of other malignancies

  • Noh, Gi Tark;Lee, Kyoung Ju;Sohn, Hee Jung;Lee, Kyung Han;Heo, Won Seok;Koh, Byung Sung;Han, Un Mi;Bae, Young A
    • Journal of Yeungnam Medical Science
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    • v.33 no.1
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    • pp.72-75
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    • 2016
  • Pulmonary epithelioid hemangioendothelioma (PEH) is a rare, low-to-intermediate malignant tumor of endothelial origin. Computed tomography (CT) findings of PEH demonstrate multiple small bilateral nodules; however, to the best of our knowledge, there were no reports on PEH coexisting with other malignancies. Here, we reported on a case involving PEH in a patient with colon cancer and breast cancer which was misconceived as pulmonary meta- stasis. A 63-year-old woman who suffered from constipation for 2 weeks visited our hospital. Colonoscopy showed a large mass with obstruction on hepatic flexure. The histological diagnosis was adenocarcinoma of the ascending colon. Multiple nodules in both lungs and breast were observed on a chest CT scan. A core biopsy of a breast nodule was performed and a diagnosis of invasive ductal carcinoma of the left breast was made. Pulmonary nodules observed on the chest CT scan was considered as pulmonary metastasis from colon or breast cancer. Laparoscopic right hemicolectomy was performed. At the same time, wedge resection of the lung was performed and pathological diagnosis was PEH. Radiologic features of PEH were difficult to distinguish from lung metastasis. Therefore the author reported a rare case involving PEH in a patient with primary malignancy of colon and breast.

Urinothorax following Blunt Renal Trauma -One case report - (신장의 둔상에 의한 요흉 - 1예 보고-)

  • Kim Dae Hyun;Youn Hyo Chul;Yi In Ho;Kim Soo-Cheol;Cho Kyu Seok;Park Joo Chul;Kim Bum Shik
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.803-805
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    • 2005
  • Urinothorax occurs when urine leakes into thoracic cavity and it was first reported by Correie in 1968. The mechanism of its occurrence is an accumulation of urine in thoracic cavity by retroperitoneal urinoma formed by urinary tract obstruction or trauma. Retroperitoneal inflammation, malignant neoplasm, kidney transplantation, and kidney biopsy can also induce urinothorax. The diagnosis of urinothorax may be delayed due to its rare incidence rate, but if diagnosis is confirmed the treatment is possible by urinary diversion. We report our experience of a case of urinothorax associated with retroperitoneal urinoma followed by blunt renal trauma with review of literatures.